Team of 'rebels' behind NUH

04-Sep-2010 (Sat) Review & Forum, The Straits Times

The National University Hospital (NUH) celebrated its 25th anniversary this week by launching a book. Health Minister Khaw Boon Wan, NUH's first CEO from 1985 to 1987, wrote a message for the book, entitled 24/7. This is what he wrote:

Having commercial tenants such as a gift shop and restaurant in the lobby helped make NUH less hospital-like and patients' experiences less intimidating and more cheerful. -- ST FILE PHOTO

WHEN I was told to get a new hospital in Kent Ridge up and running, I seized the opportunity. I gathered a team of 'rebels': people who were familiar with public hospitals but had been critical of the status quo. I told them: 'Now is your opportunity to correct the 'wrongs' and make public hospitals better. Let's make a difference.' They did not disappoint.

We made the most progress where the clinical heads were supportive of change. I remember Professor Foong Weng Cheong who was then Head of Surgery. We introduced and promoted 'day surgery', knowing that hospitalisation was costly to the patients and many operations could be carried out safely as outpatient procedures. When we started, day surgery made up less than 10 per cent of all operations. Today, more operations are being carried out on outpatients than inpatients.

I remember the late Prof Chan Heng Leong, the Head of Medicine. We renovated and furnished a day chemotherapy suite, to enable cancer patients to receive chemotherapy as outpatients in a more home-like environment.

Not all medical treatment needed to be carried out in hospitals. We became the first hospital to conduct kidney dialysis in the community. A bit inconvenient for the doctors, but a lot more convenient for the patients and their family members. This is now the norm.

The late Prof S.S. Ratnam was another legend. He had a fertile mind and wanted to push infertility and obstetrics care to a higher level but was constrained by civil service rules. I worked closely and productively with him and made a lot of headway.

We were never shy to learn from others and copy good ideas readily. From Thomson Medical Centre, I copied the concept of allowing husbands into delivery suites, to share the joy of birth with their loved ones.

We made progress not just in traditional clinical areas. We had also innovated in laboratory medicine, radiology, clinical pharmacy, physiotherapy and many other areas. I was fortunate to have sensible and creative rebels heading each of these areas.

We also set out to make hospitals less hospital-like. Hospitalisation was such a traumatic experience that we thought patients would welcome a less intimidating and a more cheerful encounter. We converted the entrance lobby and brought in commercial tenants to complete the service to our patients and visitors: bank, restaurant, florist, hairdresser, etc. When NUH opened, many visitors commented that it looked more like a hotel.

Little details made a lot of difference: For example, hospitals used to smell - well, like hospitals. We consulted a hotel housekeeper and replaced the floor cleaning disinfectant that was then used in all hospitals. We also worked with McDonald's to do up an X-ray suite so that children no longer feared going for X-rays.

It was an exciting opportunity to make patients' hospital experiences better, less stressful and cheaper. We seized such an opportunity and made a difference.

At 25, NUH must never lose that spirit of adventure, and must remain perennially motivated to want to make life better for our patients.

There is always a better way to do things and always assume that the status quo is never perfect. In particular, continue to talk to patients, get their feedback, listen to their suggestions: they have much to teach us. Talk to staff: doctors, nurses, pharmacists, physiotherapists, housekeepers; look out for 'rebels', support them and try out new ideas.

The best is yet to be for Singapore health care, and NUH must always be out there in the lead.